title: [Cardiac surgery in octogenarian patients: evaluation of predictive factors of mortality, long-term outcome and quality of life].
abstract: OBJECTIVE
  Increasing life expectancy in Western countries in the last decades has resulted in a significant gradual increasing number of octogenarians referred for cardiac surgery. There is a need for a critical evaluation of the long-term surgical outcome and quality of life in the elderly. The aim of this study is to identify risk factors of mortality in octogenarians undergoing cardiac surgery and to assess the long term survival and quality of life.
  
  
  METHODS
  Data were reviewed on 150 patients aged over 80 years--mean age (standard deviation): 82.7 (2.5) years--who underwent cardiac surgery at our institution in the last 26 years. We analyzed clinical and epidemiological variables included in the European System for Cardiac Operative Risk Evaluation (euroSCORE), in-hospital morbidity and mortality, long term survival and quality of life after cardiac surgery.
  
  
  RESULTS
  The 30-day mortality rate was 30.1%, with a mean hospital stay of 16.5 days (13-27). Emergent procedure, reparation of postinfarction ventricular ruptures, New York Heart Association functional class IV, chronic renal failure and previous myocardial infarction were independent predictors of in-hospital mortality. Mean follow up was 72.2 (9.9) months with survival rates of 87.3% and 57% at 1 and 5 years, respectively. Late postoperative quality of life in our 53 long-term survivors was significantly better than prior to surgery. New York Heart Association functional class improved from 2.52 to 1.48. Most survivors (97.7%) were satisfied with present quality of life
  
  
  CONCLUSIONS
  Cardiac surgery in octogenarians is associated with increased in-hospital mortality rate and longer hospital stay. Our findings support that cardiac surgery can be performed in a selected elderly population with good long-term survival and quality of life.
authors.affiliation: Servicio de Cardiología, Hospital Universitario La Paz, Madrid, España. avianatejedor@secardiologia.es
authors.forename: Ana
authors.initials: A
authors.lastname: Viana-Tejedor
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Domínguez
authors.forename: Mar
authors.initials: M
authors.lastname: Moreno Yangüela
authors.forename: Raúl
authors.initials: R
authors.lastname: Moreno
authors.forename: Esteban
authors.initials: E
authors.lastname: López de Sá
authors.forename: José M
authors.initials: JM
authors.lastname: Mesa
authors.forename: José
authors.initials: J
authors.lastname: López-Sendón
mesh_terms: D000367:Age Factors; D006348:Cardiac Surgical Procedures / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D017060:Patient Satisfaction; D018579:Patient Selection; D011379:Prognosis; D011788:Quality of Life; D012307:Risk Factors; D016896:Treatment Outcome